Ayurvedic Treatment of Oromandibular Dystonia

Introduction

Dystonia is a disorder related to movements where a person’s muscle contracts uncontrollably. Dystonia is classified based on three important factors: age at which symptoms develop; areas of the body affected; and the underlying cause. Dystonia is either caused due to idiopathic (primary) or follows a peripheral injury. Abnormal functioning of the basal ganglia which controls coordination of movement is responsible for dystonia to occur. Patients often tend to experience uncontrollable twisting, rhythmic, atypical, repetitive movements or abnormal postures and positions. These can affect any part of the body, including the legs, trunk, face, arms, and vocal cords. Dystonia affecting any part of the head falls under cranial dystonia. Oromandibular dystonia (OMD) otherwise referred to as focal neurological dystonia presents with forceful contractions of the jaw, face and tongue. This shows up with difficulty in opening and closing the mouth and often affects speech and chewing. OMD is further classified into 5 types as jaw opening, jaw closing, jaw deviating, lingual, and mixed types. In Ayurveda we can consider this as vata vyadhi where there is excess vata prakopa leading to symptoms like kampa (tremors) and sankocha (contractions), spandana (twitching sensations), and siro-nasa-akshi-jatru-greeva hundanam (distortion of head, nose, eyes, jaw and neck).

Causes

The exact cause and mechanism of Oromandibular dystonia are not well known. Oromandibular dystonia may be primary or secondary. Primary as same as neurological disorder where it may or may not present with (hereditary history or as secondary disease to certain drugs, injury, trauma or any particular disease. Disorders like metabolic disorders and ischemic or demyelinating lesions in the upper brain stem, neuroleptic exposure, and hypoxic brain damage can have relations to OMD. Also as mentioned earlier dystonia results from abnormally increased transmission of signals from the brain to the muscles of the face and jaw in-turn resulting in repetitive, uncontrollable twisting, rhythmic involuntary movements and closure of the jaw and face muscles.

Risk Factors

Following are the risk factors for developing OMD:

• Family History
• Certain Medications
• Heavy Metal Poisoning
• Injury
• Infections
• Secondary to Movement Disorders
• Secondary to Metabolic Disorder

Symptoms

OMD presents with the following symptoms:

• Tooth grinding
• Jaw clenching and deviation
• Jaw opening and closing
• Jaw tremor
• Lip abnormal posturing
• Difficulty in chewing
• Difficulty in swallowing
• drooling
• Slurred speech

Complications

Following are the complications OMD:

• Physical disabilities that affect daily activities
• Difficulty in speech
• Problems with vision
• Pain due to continuous contractions
• Depression
• Anxiety
• Social withdrawal

Treatment

There is no inadequate evidence-based information about specific medication for OMD. Nevertheless, anticonvulsants, anticholinergic, dopamine receptor antagonists etc are some of the medications which are chosen. physiotherapy is helpful to reduce the dystonic movements to some extent. Botulinum neurotoxins is an agent that blocks the release of acetylcholine at presynaptic junction leading to chemical denervation of muscles. There are no specific surgical therapies for OMD. In Ayurveda, Snehana followed by swedana and shodhana procedures are indicated. Apart from shodhana procedures, this condition can be managed with some of the oral medications like vata gajankush ras, ekanga veera karsa, kapikachhu churna, yogaraja guggulu, rasnadi guggulu etc.

Herbal Remedies For Diabetes By Planet Ayurveda

Planet Ayurveda has included certain effective herbal supplements which are exclusive for combating OMD. It includes:

1. Rasraj Ras
2. Yograj Guggul
3. Vrihat Vatchintamani Ras
4. Boswellia Curcumin
5. Dhanwantharam Capsule

Products Description

1. Rasraj Ras

RasRaj Ras is a well-known drug used in vata dosha (body humor) related conditions. Ras Raj Ras is a herbo-mineral preparation. It contains Rasa Sindura (purified and processed mercury), Abhrak Satva (purified and processed silica) , Swarna Bhasma (gold basma), Loha Bhasma (iron basma), Rajata Bhasma (silver basma), Vanga Bhasma (tin basma), Lavanga churna (clove powder), Ashwagandha churna (withania somnifera), etc drugs which are helpful in treating neuromuscular conditions like locked jaw, paralysis, dizziness, hemiplegia .

Dose: 1 tablet twice daily to be chewed with milk, after the meals.

2. Yograj Guggul

Yograj guggul is a tablet form drug of choice when increasing vata dosha (body humor) is to be treated. It contains shud guggulu (commiphera mukul), chitraka (plumbago zeylanica), pippali (piper longum), ela (elettaria cardamomum), amalaki (emblica officinalis), musta (cyperus rotundus) etc. it helps in strengthening muscles and strengthen the skeletal system thereby helpful in managing OMD.

Dose: Two tablets twice daily after meals with plain water.

3. Vrihat Vatchintamani Ras

Vrihat vata chintamani is a medicine which is extensively used in the treatment of various vata disorders. It contains Swarna Bhasma (gold basma), Loha Bhasma (iron basma), Rajata Bhasma (silver basma), pravala basma (coral basma), muktha basma (pearl basma) etc. it is an excellent vatashamaka, rasayana, balya. It is used effectively in healing disorders due to vata dosha like hemiplegia, facial paralysis etc. Thus, it works well in OMD.

Dose: 1 tablet twice daily to be chewed with milk, after the meals

4. Boswellia Curcumin

Boswellia curcumin is a drug which is prepared from standardized extracts of Sallaki (Boswellia serrata) and active compound of Haridra (turmeric), i.e., curcumin. Planet Ayurveda’s Boswellia curcumin is very effective in the management of treating pain, inflammation in muscles and joints, boost immunity, and provide relief from pain of Oromandibular dystonia.

Dose: 1 tablet twice a day after meals with plain water.

5. Dhanwantharam Capsule

Dhanwantharam capsule is mainly used in treating nervous system related disorders where vata is increased. It mainly works as neuroprotective, antispasmodic, nerve tonic, anti paralytic, analgesic etc. It contains various herbs like gokshura (Tribulus terrestris), ksheera kakoli (lilium polyphyllum), bilva (Aegle marmelos), manjishtha (Rubia cordifolia), amalaki (emblica officinalis), Haritaki (Terminalia chebula), ela (elettaria cardamomum) etc. All these drugs have multidimensional properties which help in strengthening muscles and the nervous system. Planet Ayurveda’s Dhanwantharam capsule is well indicated in OMD.

Dose: One tablet twice daily after meals with plain water.

Conclusion

OMD is a chronic and disabling focal dystonia presenting with forceful contractions of the jaw, face and tongue. Planet ayurveda’s above mentioned drugs are very helpful in conservative management of OMD.